神经内科门诊患者认知障碍的横断面调查

摘要

目的 通过临床流行病学(横断面调查)研究,了解综合医院神经内科门诊患者中认知障碍的患病率、认知障碍类型和影响因素.方法 从2009年9月14日～12月25日(历时3个月),对温州医学院附属第一医院神经内科门诊患者进行认知筛查,筛查方法为:三步法.第一步:老年人认知功能减退知情者问卷(IQCODE)筛查,如IQCODE得分≥3.3分则进入第二步;第二步:简明精神状态检查(MMSE)筛查,如MMSE异常则进入第三步;第三步:痴呆或认知障碍评定,并进行分类诊断.结果 神经内科门诊患者总量为22078人次,符合筛查标准完成筛查量为20367人次,总筛查率为92.25%,认知障碍119人,占0.058%,其中轻度认知障碍47人,痴呆72人,其中:阿尔茨海默病源性认知障碍(MCI-A)24人,血管源性认知障碍(MCI-V)10人,混合性认知障碍(混合性MCI)8人,其他认知障碍5人;阿尔茨海默病(AD)28人,血管性痴呆(VD)19人,混合性痴呆19人,其他痴呆6人.结论 神经内科门诊患者中轻度认知障碍及痴呆患者的比例及其高危因素潜在人群在门诊患者中占20%左右.轻度认知障碍以阿尔茨海默病源性认知障碍最多,血管源性认知障碍和混合性痴呆其次,痴呆以阿尔茨海默病最多,血管性痴呆和混合性痴呆其次.%Objective To understand prevalence, patterns and risk factors of cognitive impairment in the patients fiom the neurology clinic of a general hospital through a clinicopathological study ( cross - sectional study ). Methods The patients fiom neurology clinic of the first affiliated hospital to Wenzhou medical college were screened for cognitive impairment in the period fiom September 14, 2009 to December 25, 2009( 3 months in total ). The screening method was three - step method. In the first step: screening Informant Questionnaire on Cognitive Decline, all patients were involved in. In the second step: screening MMSE, the patient could be involved in the study if his／her IQCODE score ≥ 3.3. In the third step: assessing dementia or cognitive impairment, and diagnosing in classification,the patient could be involved in the study if his／her MMSE was abnormal. Results There were 20367 of the total 22078 patients form the neurology clinic metting the screening criterion,and the overall screening rate was 92.25％. There were 119 patients who had cognitive disorders( 0. 058 ％ ),47 of which had mild cognitive impairment, 72 of which had dementia, including 24 patients with mild cognitive impairment of Alzheimer's disease type( MCI - A ), 10 with mild cognitive impairment of vascular type( MCI - V ), 8 with mixed mild cognitive impairment ( mixed MCI ), 5 with other cognitive disorders, 28 with Alzheimer's disease ( AD ), 19 with vascular dementia ( VD ), 19 with mixed dementia, and 6 with dementias. Conclusion The rate of the patients with mild cognitive impairment, dementia and other potential risk factors was about 20％ in the patients form the neurology clinic. For the mild cognitive impairment,the number of the patients with mild cognitive impairment of Alzheimer's disease type was the greatest, and the second ones were the patients with mild cognitive impairment of vascular type and mixed dementia.